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The purpose of the present study was to evaluate the efficacy and safety of bipolar transurethral prostatectomy (TURP) using the Gyrus™ PlasmaKinetic System compared with conventional monopolar TURP. This study included 102 patients with benign prostatic hyperplasia (BPH) who underwent TURP from January 2003 to March 2005. In all, 49 consecutive patients had bipolar and 53 had monopolar TURP. All patients were assessed by preoperative and postoperative International Prostate Symptom Score (IPSS), uroflowmetry, transrectal ultrasonography, operative time, weight of resected tissue, change in serum sodium and hemoglobin, duration of catheter use, length of hospital stay, and complication rates. Significant improvement was seen postoperatively in both groups, and no difference was observed in the resection time, weight of resected tissue, change in serum sodium and hemoglobin, improvement of IPSS and peak flow rate (Qmax), or complication rates over the 12-month follow-up in both groups. There was, however, a significant difference in duration of catheter use and hospital stay. Duration of catheter use (2.28 days vs. 3.12 days) and hospital stay (3.52 days vs. 4.27 days) were shorter in the bipolar group ( p = 0.012 vs. p = 0.034, respectively). Our results demonstrate that bipolar TURP using the Gyrus™ Plasma Kinetic System is as effective as conventional monopolar TURP with the additional advantage of reduced length of catheter use and hospital stay. Bipolar TURP is a promising new technique that may prove to be a good alternative to conventional TURP in the future.

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Purpose: We assessed the efficacy and safety of solifenacin compared with tolterodine for treatment of overactive bladder (OAB) in Korean patients. Materials and methods: The study was randomised, double-blind, tolterodine-controlled trial in Korea. Patients had average frequency of ≥ 8 voids per 24 h and episodes of urgency or urgency incontinence ≥ 3 during 3-day voiding diary period. Patients were randomised to 12-week double-blind treatment with either tolterodine immediate release (IR) 2 mg twice daily (TOL4) or solifenacin 5 mg (SOL5) or 10 mg (SOL10) once daily. The outcome measure was mean change in daily micturition frequency, volume, daily frequency of urgency incontinence, urgency and nocturia from baseline to week 12. Quality of life was assessed using the King’s Health Questionnaire. Results: A total of 357 were randomised and 329 were evaluated for efficacy. All voiding parameters recorded in micturition diary improved after treatment in all three groups. Mean changes in volume voided were 19.30 ml (26.69%) in TOL4, 30.37 ml (25.89%) in SOL5 and 37.12 ml (33.36%) in SOL10 group (p = 0.03). Speed of onset of SOL10 efficacy on urgency incontinence was faster than that of SOL5 and TOL4. Quality of life improved in all three groups. Dry mouth was the most common adverse event; its incidence was the lowest in SOL5 group (7.63%, compared with 19.49% and 18.64% in SOL10 and TOL4 groups respectively). Conclusions: Solifenacin succinate 5 and 10 mg once daily improve OAB symptoms with acceptable tolerability levels compared with tolterodine IR 4 mg. Solifenacin 5 mg is a recommended starting dose in Korean patients with OAB.

We analysed the long-term results, the variables predictive of cure rates, and patient satisfaction. RESULTSThe overall 7-year cure rate was 84.6%, with a satisfaction rate of 69.3%. The cure rates were lower in patients with high-grade SUI (50% in grade III, 82.8% in grade II and 90.7% in grade I; P < 0.001). On multivariate analysis, there were no independent risk factors related to cure rate, and urgency was the only factor independently associated with patient satisfaction ( P = 0.008; odds ratio 2.47). Seventy-one patients (23.2%) had complications at the 1-month follow-up after surgery, but only eight (2.6%) had complications at the 7-year follow-up, including mesh exposure in six and de novo urgency in two. CONCLUSIONThe absence of long-term adverse events associated with the TVT procedure, and high subjective and objective 7-year success rates with no independent predictive factors affecting the long-term cure rate, make the TVT procedure a recommendable surgical treatment for female SUI. KEYWORDSstress urinary incontinence, outcome, tension-free vaginal tape Study Type -Therapy (outcomes research) Level of Evidence 2c OBJECTIVETo evaluate the long-term results and predictive risk factors for efficacy after the tension-free vaginal tape (TVT) procedure for treating female stress urinary incontinence (SUI). PATIENTS AND METHODSInall, 306 women (mean age 50.7 years, SD 8.7) who had a TVT procedure for SUI were selected and followed ≥ 7 years (mean 92.3 months, range 84-110) after surgery.